Medicare Question--Houston

History: Banded 8/08, paid by BCBS, band removed 10/14, paid by Aetna & Medicare. My question is will Medicare pay for sleeve? Doctor I talked to said Medicare WILL NOT pay for more than 1 WLS. I said BCBS paid for my first surgery. Called Aetna, they will cover 80% after $6k out of pocket. Medicare said they pay if you meet requirements.  Who is right? Very confused, please advise! Thx!

Nobody here can really answer that. All plans are different and they can't really comment to yours. Is the medicare through Aetna? Is it managed medicare? I would ask them to send you in writing a second procedure is covered. 

The short answer, maybe.  The Medicare info says they do pay for sleeve.  However, my Center's insurance guy said it's difficult to get Medicare to pay for sleeve even though the info says they cover it.  Coverage for VSG is new so maybe not all Medicare employees are aware of the change.

MEDICARE pays 80% you or your gap insurance will have to pay 20% my total bill was around $160,000 So I hope you have the insurance. No matter what it is worth it. I LOST 120 pounds in 5 months. I believe medicare has requirements you must have at least 3 of these,bmi 35 or greater.diabetes,sleep apnea,morbid obesity,high blood pressure,weight loss failure. Good luck and i hope you like jello and cream of wheat.

Thanks for the replies. I will have Medicare send me their policy in writing & any exclusions! Good luck to you all!

It's a good idea to have the policies/coverages booklet at home.  Meanwhile, if your seach for weight loss surgery on medicare.gov you can find the policies.

The differences in prices blows my mind. I think total between hospital stay and everything else it was below 20K for mine. I paid 500.